1605DC-19-R-00030_-_Kansas_City_-_PWS_with_Track_Changes_5.24.2019.pdf

SECTION B – SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS

B.1. General

The contractor shall furnish Medical Second Opinion (SECOP) services and Medical Examination services for the U.S. Department of Labor, Office of Workers’ Compensation Programs (OWCP), Division of Federal

Compensation (DFEC) Kansas City District Office in accordance with the terms and conditions set forth in the solicitation document (including all amendments/modifications), and the resulting contract.

B.2. Minimum/Maximum Requirements

The minimum guaranteed quantities on this contract shall not exceed one (1). In addition, the total amount estimated maximum quantities shall not exceed the “Total Not-To-Exceed Amount(s)” identified in the

Schedule of Supplies/Services.

B.3 Payment for Necessary Supplemental Consultations, Diagnostic laboratory Tests and

Diagnostic Procedures and other related services

The Contractor shall invoice/bill diagnostic testing and procedures using the appropriate CPT or HCPCS code.

Any use of OWCP specific codes outside the requirements of this contract is strictly prohibited unless otherwise authorized by DFEC in writing for each incident. To reduce the chances of duplicate billing/invoicing, the contractor shall ensure no physician directly invoice/bill the government for these services.

Professional consultations, radiology procedures, diagnostic laboratory tests and other diagnostic procedures deemed necessary to complete a second opinion examination will be paid according to the OWCP fee schedule limitations provided under 20 CFR 10.805-813. Interpretive and transportation services require prior

Government notification and approval (when possible) and supporting documentation (as applicable).

Transportation will be reimbursed at the GSA Per Diem Rate.

All services shall be invoiced/billed and paid in accordance with the OWCP fee schedule limitations provided under 20 CFR 10.805-813 using the appropriate CPT or HCPCS code. The DFEC District office will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment.

B.4 Payment for Second Opinion Examinations, Impairment Rating Examinations, File Reviews, Supplemental Reports and Follow-Up Reports

When all medical examination and report requirements have been rendered and verified accurate, the Contractor shall submit one (1) invoice/bill for services along with a copy of the medical report to the Kansas City District

Office. Specific OWCP codes shall be supplied to the Contractor for invoicing/billing. The use of OWCP specific codes shall be strictly prohibited outside the performance of this contract. Once the DFEC District office has reviewed the report for accuracy and viability, the invoice/bill charges shall be reviewed, verified and certified, and the invoice/bill shall be submitted for payment by the District Office. The absence of the required report documentation shall result in the non-certification of the invoice/bill and non-payment. Payment for services shall not be initiated until the Contractor has met all the reporting requirements and DFEC has deemed the report viable. Once DFEC has deemed the report viable, the invoice/bill shall be submitted in accordance with Federal Acquisition Regulation (FAR) Clause 52.232-25 Prompt Payment Act and OWCP invoicing/billing procedures. All related interpretive and transportation services require prior Government notification and approval (when possible) and supporting documentation (as applicable). All pre-approved travel cost (when applicable) will be reimbursed at the GSA Per Diem Rate.

B.5 Pricing and Estimated Quantities

The Contractor shall provide the SECOP and medical examination services, as specified elsewhere in the

Schedule, at the firm fixed price per unit specified herein. All terms and conditions of the initial contract shall remain unchanged, except as where expressly and formally modified by both parties, when applicable. The following prices indicate the sole rate of reimbursement under this contract. The price is inclusive of any/all labor, indirect costs, materials, pick-up and delivery, ancillary costs and applicable fees. In addition, the total amount estimated for the maximum quantities below shall not exceed the “Total Not To Exceed Amounts” indicated below.

BASE PERIOD POP: 07/01/2019 -6/30/2020

DFEC

Unit Unit

Each

Total Units

Per Year

Rate Total

CLIN 0001 Medical Second

Opinion Services

1 1 1100 $ $

CLIN 0002 Schedule Award

Only

1 1 500 $ $

CLIN 0003 File Review Only 1 1 100 $ $

CLIN 0004 Supplemental

Reports

1 1 100 $ $

CLIN 0005 Follow Up Report 1 1 100 $ $

FTE 5 Total $

Option Period 1 POP: 07/01/2020-

12/31/2020

DFEC

Unit Unit

Each

Total Units

Per Year

Rate Total

CLIN 1001 Medical Second

Opinion Services

1 1 550 $ $

CLIN 1002 Schedule Award

Only

1 1 250 $ $

CLIN 1003 File Review Only 1 1 50 $ $

CLIN 1004 Supplemental

Reports

1 1 50 $ $

CLIN 1005 Follow Up Report 1 1 50 $ $

FTE 5 Total $

Period of Performance July 01, 2019 - June 30, Base Period Amount $

July 01, 2020 - December

31, 2020

Option Period 1 $

Total Contract Value

NTE

SECTION C – PERFORMANCE WORK STATEMENT

PART 1

PERFORMANCE WORK STATEMENT

C.1.1. Description of Services/Introduction:

In accordance with Federal Acquisition Regulation 37.401, the services required are for non-personal services to manage and provide medical second opinion and examination services in accordance with the Performance

Work Statement (PWS).

The Government will provide guidance within the general scope of the PWS and within contract terms and conditions but the Government will not exercise any supervision (or control) over the contractor’s employees.

Such contract employees shall remain under the contractor’s direct supervision (and control) at all times during the entire performance period. This also applies to the subcontracted service providers utilized in performance of these services.

The Government will evaluate the quality of professional and administrative services rendered but retains no control over the medical or professional aspects of those services (e.g. professional judgements, diagnosis for specific medical treatment etc.). Such service providers will be considered independent subcontractors responsible for performing medical second opinion and other related services. All subcontracted service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government to ensure services are managed and rendered in accordance with the general scope and within contract terms and conditions.

C.1.2. Background:

The Office of Workers' Compensation Programs (OWCP) is responsible for administration of the Federal

Employees' Compensation Act (FECA). The Act provides for medical benefits, wage-loss replacement, survivors' annuities, and other benefits to employees of the United States or their survivors when the employee is injured or dies in the course of employment. The OWCP, through the Division of Federal Employees'

Compensation (DFEC), coordinates the activities of twelve District Offices. These District Offices have direct responsibility for processing claims. The District Office functional operations include: adjudicating incoming claims to determine eligibility for compensation payments; managing claims in which eligibility has been established; determining wage-loss compensation payments for covered disability or death; and processing payments for allowed medical and vocational rehabilitation services incurred in the treatment of injured workers covered under the Act.

Under the FECA, medical care and compensation for wage loss and for permanent physical impairment are provided to Federal employees who are injured in the performance of duty. The medical evaluation of workers who submit compensation claims is part of the adjudication and case management process. A medical evaluation may be necessary: (1) to determine the causal relationship between work factors and the disease or injury; (2) to assess the extent and duration of the physical impairment or disability; (3) to determine the appropriateness of therapy, including some surgical procedures; or (4) to determine when recovery has occurred and a return to work is feasible.

In certain instances, the DFEC must refer a claimant to a specialist in an appropriate field for a second medical opinion. The second opinion is based on and shall include a review of appropriate claim file material, a physical or psychiatric examination of the claimant, the performance of any clinical or laboratory tests deemed necessary in the diagnostic work-up and a narrative medical report responding to specific questions posed by a claims examiner. In addition to specific questions, the claims examiner provides a Statement of Accepted Fact

(SOAF) which contains the information concerning events, working conditions and employment data accepted as factual by the DFEC. As such, the SOAF is the framework which the physician must use in answering the specific questions and in developing the evaluation report.

C.1.3. Objectives:

The Government’s objective is to procure Medical Second Opinion (SECOP) and Examination services for affected claimants who reside within the area served by the Office of Workers’ Compensation Programs’

Kansas City District Office.

The important elements of these services shall be the delivery of a quality, viable medical report(s), the verification and replication of impairment ratings by a reliable, certifiable and standardized process and the timeliness of scheduling medical reports. To be acceptable, the medical reports shall present comprehensive, unequivocal, unbiased and well-reasoned narrative opinions that are consistent with objective medical evidence or testing, physical or psychological findings that are consistent to the framework of the SOAF or provide a clear comprehensive, well-reasoned opinion disputing any of the medical conditions outlined in the SOAF that are unsubstantiated with any medical findings, and that address all questions posed by the claims examiner.

The timely scheduling of appointments for examinations shall be maintained within the timeframes set forth in this solicitation and within the government’s acceptance of the number of physicians available by “required” specialty and within the designated Metropolitan Statistical Area (MSA) to limit the inconvenience to FECA claimants. The timely delivery of a quality, viable medical reports contributes to prompt and accurate adjudication of claims.

C.1.4. Scope:

The contractor shall provide adequate and sufficient numbers of key personnel in order to manage and provide medical second opinion and examination services within the timeframes required and within the region to be served. (See Part 2 - Definitions/Acronyms for specific information regarding the region to be served)

The services required include medical second opinion and examination services, schedule awards, follow-up reports, supplemental reports, impairment ratings, file reviews and other diagnostic testing related services as prescribed in Part 5. Upon contract award, the successful contractor shall have the ability to:

1) manage and provide sufficient numbers of qualified and appropriate medical specialists within the region to be served and within a reasonable commuting distance of each claimants residence;

2) arrange timely scheduling of appointments for examinations and forward letters from the responsible claims examiners notifying claimants, their appointed representatives, and their employers of the claimants' responsibilities to appear and cooperate with scheduled medical exams;

3) provide a secure website (password protected [https protocol/SSL]) that is operational and available for the initiation of referrals and uploading of all pertinent imaged documents;

4) assure timely pick-up and delivery of all pertinent documents to and from the Government, contractor and subcontractor (as applicable);

5) assure the timely delivery of all medical reports within no more than 35 days;

6) provide detailed quality assurance in order to ensure each medical second opinion report is comprehensive, unequivocal, unbiased, well-reasoned, consistent with the physical findings, responsive to all questions posed by the claims examiner and presented in a form and format specified by the OWCP;

7) assure timely uploading of all documents to the secure website;

8) assure timely return delivery (to the District Office) of all Government Furnished Property (GFP) including completed medical second opinion reports and original claim file materials;

9) assure compliance with applicable provisions of the Privacy Act of 1974 and the security and confidentiality of claimant medical records (and related materials) entrusted to the custody of the contractor or examining physician.

Incorporation of Contractor's Proposal

It is understood and agreed that the contractor shall meet all of the requirements identified within this contract when performing the work in accordance with the Performance Work Statement, all solicitation amendments/modifications, the contractor’s final proposal and the resulting contract. However, in the event the contractor’s proposal conflicts with any Government provision or clause or the Articles set forth herein are in conflict or inconsistent with any provisions of the contractor’s proposal, the provisions of the Articles of the resulting contract shall be controlling and shall supersede the provisions of the contractor’s proposal.

C.1.5. Period of Performance:

The period of performance shall be for one (1) Base Period of 12 months and one (1) 6-month option period.

The Period of Performances are as follows:

Base Period: 07/01/19 - 06/30/20

Option Period I: 07/01/20 –12/31/20

The Government reserves the right to extend the term of this contract at the prices set forth in Section B in accordance with the terms and conditions contained in clause 52.217-9 entitled, “Option to Extend the Term of the Contract”.

C.1.6. General Information

C.1.6.1. Quality Control (QC):

The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop quality control procedures consistent with the PWS requirements and that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”. After the government’s review and acceptance of the quality control plan, the contractor shall be notified (in writing) by the contracting officer who will indicate any proposed change(s) to the QC system (when applicable).

C.1.6.2. Quality Assurance:

The government shall evaluate the contractor’s performance under this contract in accordance with the Quality

Assurance Surveillance Plan (QASP) identified in Technical Exhibit 1 and Attachment J.3. The QASP is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

C.1.6.3. Government Remedies:

The contractor shall have the opportunity to correct unsatisfactory services or deficiencies within five calendar days or another agreed upon timeframe but in no case will the Government pay for non-forming services.

Failure to comply with the requirements of this PWS and may result in monetary penalties and administrative remedies as defined at FAR 42.15 “Contractor Performance Information, 52.212-4 “Contract Terms and

Conditions-Commercial Items or 52.246-4 “Inspection of Services-Fixed Price, depending on the nature and impact of the deficiency.

C.1.6.4. Recognized Holidays:

The contractor shall not schedule examination services on the following holidays:

New Year’s Day Labor Day

Martin Luther King Jr.’s Birthday Columbus Day

President’s Day Veteran’s Day

Memorial Day Thanksgiving Day

Independence Day Christmas Day

C.1.6.5. Hours of Operation/Place of Performance:

The contractor is responsible for conducting business between the hours of 8:00am to

5:00pm (or as established by the District Offices local time zone) Monday thru Friday (except

Federal Holidays) or when the Government facility is closed due to local or national emergencies, administrative closings or similar Government directed facility closings as applicable for the region to be served. The contractor must at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this performance work statement when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the work force are essential. Telecommuting or “work at home” is not authorized unless under emergency situations as determined by the COR.

C.1.6.6. Type of Contract:

The government anticipates award of a Firm Fixed Price, indefinite delivery, indefinite quantity (IDIQ) type contract for the services identified in the “Schedule of Services/Supplies”.

C.1.6.7. Security Requirements:

NOTE: All references to keys include key cards. No keys issued to the Contractor by the

Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the Quality Control Plan. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the Contracting Officer.

C.1.6.7.1. Physical Security.

When applicable, the contractor shall be responsible for safeguarding all Government Furnished Property identified and provided for contractor use (See Part 3 – Government Furnished Property). At the close of each work period, all government facilities, equipment, and materials shall be secured appropriately (when applicable).

C.1.6.7.2. Key Control.

When applicable, the Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons.

C.1.6.7.3. Lost Keys

In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the

Contracting Officer, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

C.1.6.7.4. Key Use

When applicable, the Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

C.1.6.7.5. Lock Combinations.

When applicable, the Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s Quality Control Plan.

C.1.6.8 Conservation of Utilities.

The contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

C.1.6.9 Special Qualifications/Requirements:

C.1.6.9.1. Case Transfers and Loans

Transfers occur most often because the claimant or beneficiary has moved to another jurisdiction. Loans occur most often between the DOs and the National Office (NO). The NO may request cases for review by OWCP.

Once a case is determined transferred or loaned, the Systems Manager or designee will transmit the electronic records, including ACPS records and Bill Processing System records through the Debt Management System

(DMS). OWCP staff will notify all interested parties of the transfer; change the location code to reflect the transfer; and send the file by certified mail to the requesting office.

Cases pending at the end of contract performance may only be transferred from the existing contract to new contract if approved by DO COR. The incumbent must request written approval from the District Office COR and ensure reporting requirements and billing and invoicing DO NOT DUPLICATE.

C.1.6.9.2. Conflict of Interest

The contractor shall not engage in scheduling or executing medical examination services at the request of an injured federal worker, another federal agency or any other entity that would give the appearance of a conflict of interest. Any referral request to perform medical examination services for a DFEC workers’ compensation case received from a source other than the Kansas City District Office may not be performed without the

Contracting Officer’s approval.

The Contractor shall provide a plan to ensure physician and medical specialists are not engaged in providing workers’ compensation, disability or impairment rating medical examination services for other government agencies prior to the use of such physician or medical specialist. The Contractor shall ensure verification is conducted prior to the execution of the scheduled medical examination service.

The Contractor shall also ensure that a conflict of interest does not exist between the scheduled qualified physicians or medical specialist, the claimant, with the claimant’s treating physician, with any physician previously providing services to the claimant, or with any staff member employed by the scheduled qualified physician or medical specialist who may know or have knowledge of the claimant. A conflict of interest exists when the Contractor’s scheduled physician, medical specialist or their staff has either a direct familial or marital relationship, a past or current personal or professional relationship, with the claimant or the physicians providing medical care relating to the claimant’s workers’ compensation claim.

C.1.6.9.3. Freedom of Information Requests

The Government may receive requests for information under the requirements of the Freedom of Information

Act (FOIA). Executive Order 12600, issued June 23, 1987, and Department of Labor Regulation §70.26, provide for pre-disclosure notification to submitters of records if confidential commercial information is contained in the records requested under the FOIA. A “submitter” means any person or entity who provides commercial or financial information to the government. “Confidential commercial information” is defined as records provided to the government by a submitter that arguably contain material exempt from release under

Exemption 4 of the Freedom of Information Act, 5 U.S.C. 552(b)(4), because disclosure could reasonably be expected to cause substantial competitive harm.

In the event the Government receives a FOIA, a notification will afford the company (the submitter), or its designee, a reasonable period of time in which to object to the disclosure of any specific portion of the information contained in the records, and to state all grounds upon which disclosure is opposed under

Exemption 4 of the FOIA. Any claim of competitive harm must be supported by facts explaining how release of this information could be used by competitors to disadvantage your company. The contractor will be provided 7 days from date of the Government’s notification to provide a written response by email, mail, fax, or both, of any objections the submitter may have to the release of specific information contained in your proposal which may be deemed to be confidential commercial or financial information under Exemption 4 of the FOIA.

All statements should support and justify the claim(s), as they will be used in conjunction with other information to make a final determination as to its release.

Please note that failure to provide comments within 7 days will be considered a non-response and thus the submitter’s full consent to release the information in total, subject to FOIA exemptions or federal statutes prohibiting the release of such information. In addition, prior to the Government’s decision to release such records, the Government will notify the submitter of the Governments decision. Any additional comments received will be reviewed for their altering impact prior to the release of records.

C.1.6.9.4. Correspondence or Telephone Inquiries Related to DFEC Claims or Claimants

All correspondence or telephone inquiries involving specific OWCP/DFEC claims or claimants should be documented and referred to the District Office COR for appropriate action. At no time shall the contractor disclose the name(s) (either written/verbal) of Government Official(s) associated with the processing of

OWCP/DFEC claims without the consent of the DO COR.

C.1.6.9.5. Reports of Fraud

All OWCP contractors or providers are expected to report fraud or suspected abuse whenever suspected in the claims process. Whenever an OWCP contractor or provider is contacted by an individual, whether a private citizen or government official, with allegations or information regarding suspected fraud related to a FECA claim, the individual will be referred immediately to the District Office COR or District Director for further action. Individuals may also call the Hotline at 1(800)347-3756.

C.1.6.9.6. Transportation Services

During the entire performance of these services, each contractor is expected to demonstrate and utilize maximum cost control measures in order to minimize the need for claimant travel beyond the 100 mile radius outside each urban MSA cluster.

When transportation services are required to obtain medical care and transportation is not furnished by the government, the employee may be reimbursed for travel expenses. Travel should be undertaken by the shortest route and by public conveyance such as bus or subway unless the employee's medical condition requires the use of a taxicab or specially equipped vehicle. An employee who uses his or her automobile will be reimbursed at the standard mileage rate for government travel.

All items will be reimbursed on the basis of actual expense; a per diem allowance is not payable. Wages and travel expenses of an attendant to accompany the employee may be approved if his or her condition is such that travel cannot be accomplished otherwise. Authorization for this expense should be obtained in advance of the travel, if possible. A letter requesting services must be sent to the DO COR. The letter should show the date of the request, the name of the employee, the case file number, provider and the scheduled appointment.

C.1.6.9.7. Privacy

Portions of information disclosed during the performance of this task are protected by the provisions of the

Privacy Act of 1974; therefore, all personnel assigned to this Contract shall be required to take proper precautions to protect the information from disclosure. The Contractor shall ensure that any disclosure or breach of private, personal or medical information shall be immediately reported to the Contracting Officer and the National Office COR within one (1) hour. The Contractor shall have a process in the event of a breach or disclosure that also includes corrective action. The Contractor shall submit a privacy disclosure or breach of personal information plan to the government in their proposal.

C.1.6.10 Personal Information and Privacy

The contractor shall provide personal information and privacy support to ensure compliance to the Privacy Act and other Federal Privacy related policies including, but not limited to, OMB Memorandum M-06-16, Protection of Sensitive Agency Information, and M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information. This support shall include the review and evaluation of the Privacy

Impact Assessments (PIAs) for all systems containing DOL sensitive and PII information. The review shall ensure that the systems comply with the appropriate regulations pertaining to personally identifiable information (PII). The contractor shall evaluate the current PIA methodology and tracking system; and provide recommendations to make the processes and/or system more efficient and effective. The contractor shall evaluate their existing Departmental Privacy related policies and procedures to ensure they comply with federal

Privacy related policies. Where the Contractor’s departmental policies and procedures do not comply, the

Contractor shall perform the necessary updates/revisions to bring the documents and/or system into compliance as requested by the Contracting Officer or COR at no additional cost to the government. The contractor shall also ensure that all identified privacy vulnerabilities and areas of noncompliance have been documented and resolution tracked.

The Contractor shall ensure that its second opinion medical examination services solution maintains conformance to the most recent DOL implementation of Federal information security guidelines, currently defined as:

The Freedom of Information Act, as amended (5 USC 522), which provides for the disclosure of information maintained by Federal agencies to the public, while allowing limited protection for privacy.

The Privacy Act of 1974, as amended (5 USC 522a), including the Computer Matching and Privacy Act of

1988 (Public Law 100-503).

The Computer Security Act of 1987 (Public Law 100-235), which established minimum security practices for Federal computer systems.

The Federal Information Security Management Act of 2002, which established the requirement for all information systems operated by or on behalf of the United States Government to be certified and accredited as satisfying the minimum information security requirements established by statute, regulation, and National Institute of Standards and Technology (NIST) standards and guidance materials.

OMB Circular A-130, Management of Federal Information Resources, which provides instructions to

Federal agencies on how to comply with the fair information practices and security requirements for operating automated information systems.

OMB Memorandum M-07-16, Safeguarding Against the Breach of Personally Identifiable Information, May 22, 2007.

OMB Memorandum M-06-19, Reporting Incidents Involving Personally Identifiable Information and

Incorporating the Cost for Security in Agency Information Technology Investments, July 12, 2006.

OMB Memorandum M-06-16, Protection of Sensitive Agency Information, June 23, 2006.

OMB Memorandum M-06-15, Safeguarding Personally Identifiable Information, May 22, 2006.

FIPS PUB 199, Standards for Security Categorization of Federal Information and Information Systems.

http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf

FIPS PUB 200, Minimum Security Requirements for Federal Information Systems.

http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf

NIST Special Publication (SP) 800-53, Recommended Security Controls for Federal Information Systems.

http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf

US DOL Computer Security Handbook (DOL’s implementation of NIST SP 800-53). (Reference

Attachment 25 - Computer Security Handbook 3.0)

DLMS – 9 – Chapter 1200, DOL Safeguarding Sensitive Data Including Personally Identifiable

Information (Reference Attachment 26 - Department of Labor Manual Series (DLMS) 9 Chapter 1200)

C.1.6.10.1 Privacy Responsibilities

(a) The Contractor shall ensure that every employee completes all mandated Federal Ssecurity tTraining requirements prior to the employee’s first day of work under the second opinion medical examination services contract unless the Government provides a signed waiver agreement.

(b) The Contractor shall ensure that all information and reports generated under the terms of this contract are, and shall always remain, the property of the Government.

(c) The Contractor shall protect the Personally Identifiable Information (PII) of all claimants, providers, and

Government employees from unauthorized disclosure.

(d) The Contractor shall use a Government-approved reporting mechanism, tool or form to notify the

Government of all security incidents, disclosures, breaches, disasters involving Personally Identifiable

Information (PII) within one (1) hour of becoming aware of the incident. This written notification shall describe the security incident, disclosure, breach or disaster in detail and state the measures taken to protect the confidentiality, integrity and availability of OWCP information. The contractor’s plan shall be included in the proposal and the Quality Assurance Plan.

(e) The Contractor shall take no action until the OWCP National Office and Contracting Officer is notified and provides direction. The District Office COR is not authorized to respond or act on behalf of the OWCP

National Office on security incidents, disclosures, breaches or disasters involving PII.

(f) The government shall approve the Contractors resolution to the incident.

(g) The contractor shall be responsible for any liability resulting for the security incident, disclosure or breach involving a claimant’s PII, including financial harm to the government.

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public

Money, Property or Records). The Contractor shall not use or disclose any case information for study, research or any other circumstance without the express written Contracting Officer’s approval.

C.1.6.11 Post Award Conference/Periodic Progress Meetings:

The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

C.1.6.12 Contracting Officer Representative (COR):

The resulting contract will be monitored by the following individual COR’s: (Note: TBD at time of award)

District Office COR

National Office COR

Note: When N/A is indicated for the National Office COR, the Contracting Officer reserves the right to retain and execute such COR duties until otherwise designated and authorized in writing.

The District Office and National Office COR shall be identified by separate letter. Each COR monitors all technical aspects of the contract and assists in contract administration. Both CORs are authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform the oversight necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies. A letter of designation issued to both the District Office COR and the National Office COR will be issued stating their responsibilities and limitations. A copy will also be forwarded to the Contractor outlining those responsibilities and limitations, especially with regard to changes in cost or price, estimates or changes in delivery dates. The District Office or National Office CORs are NOT authorized to make changes to any of the terms and conditions of the resulting contract. Changes shall only be made by the Contracting Officer.

C.1.6.13 Contract Manager:

The contractor shall provide a contract manager who shall be responsible for the performance of the work required by the contract. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act on behalf of the contractor on all contract matters relating to daily operation of this contract.

The Contractor hereby certifies to the accuracy of all resumes of persons currently proposed or assigned to this contract. In the event, any such person is replaced (for any reason), the contractor shall notify the Government, in writing within 24 hours. The contractor is responsible for ensuring continuity of services and shall propose a replacement within three days or another date agreed upon by the District Office COR.

C.1.6.14 Identification of Contractor Employees:

All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

PART 2 - DEFINITIONS & ACRONYMS

C.2.1 Definitions

The following definitions are specific the DFEC medical examinations and accepted by the Office of Workers’

Compensation Programs

Types of Causal Relationship:

Under the FECA, an injury or disease may be considered as employment-related in any one of several ways.

The FECA contains no provision for apportionment, and the Office shall pay for all medical and compensation expenses due to impairments which result from an employment injury.

Direct Causation. This type of relationship exists when the injury or factors of employment result in the claimed condition through a natural and unbroken sequence. An acute trauma, such as a fall from a ladder, exemplifies this type of causal relationship.

Direct causation may be identified in both traumatic injuries and occupational diseases. However, the amount and sophistication of the medical documentation necessary to establish this relationship in claims for occupational diseases are usually greater because of the multifactor etiologies and clinical complexities of some of these diseases.

Aggravation. This type of relationship exists when a preexisting condition (not necessarily employment-related) is intensified or exacerbated by an employment-related injury or factor. If this type of causality is identified by the consultant, it is imperative that it be categorized as temporary or permanent.

(1) Temporary aggravation involves an exacerbation of a pre-existing condition which will last for a finite period of time, after which the employee returns to his or her baseline physical status. For instance, an acute asthmatic attack is triggered in an employee known to have asthma by the exposure to formaldehyde fumes in the work place. In such a case, compensation is payable only for the period of exacerbation established by the medical evidence and not for any disability caused by the underlying disease.

(2) Permanent aggravation constitutes an exacerbation of an underlying condition which persists indefinitely or produces irreversible anatomical and/or physiologic changes so that the employee does not return to his or her previous status. Identification of this type of causality requires thoughtful evaluation of the medical documentation in the case file. The physician should describe the way in which the underlying condition has been irreversibly affected by the work aggravation. Objective rational is critical to the establishment of a permanent aggravation and the physician must fully explain how the underlying condition has been irreversibly altered by the work factor.

Acceleration. Acceleration is said to occur when an employment-related injury or work factor hastens the clinical manifestation of a latent condition in a manner which cannot be explained by the natural history of the disease. In the context of the FECA, this type of causality carries the same weight as direct causation;

compensation and medical benefits are reimbursed on an indefinite basis.

Precipitation. Precipitation involves the clinical manifestation of a quiescent condition which is prompted or caused by factors related to employment. It is different from acceleration in that the work factor or injury is actually necessary for the development of the condition, whereas acceleration refers only to the clinical appearance of a disease sooner than expected.

Consequential Injury. This is an injury which occurs because of weakness or impairment caused by a work-related injury. It may affect the same part of the body as the original injury or a different area altogether. For instance, a claimant with an accepted knee injury may fall at home because the weakened knee has buckled; this incident will constitute a consequential injury whether the affected part of the body is the knee or some other area, such as the back or arm. Or, a claimant with an injured eye may compensate for loss of functioning by overuse of the other eye, which may result in a consequential injury. The consultant may be asked to give an opinion concerning the causal relationship of the second injury to the first.

Contracting Officer’s Representative (COR). A representative from the requiring activity assigned by the

Contracting Officer to perform surveillance and to act as liaison to the contractor

Defective Service. A service output that does not meet the standard of performance associated with it in the Performance Work Statement.

Quality Control. Those actions taken by a contractor to control the performance of services so that they meet the requirements of the PWS. An organized written document (Quality Control Plan) specifying the quality control methodology will be used for demonstrating the contractor’s approach to meeting contract requirements.

Quality Assurance. Those actions taken by the government to assure services meet the requirements of the Performance Work Statement. An organized written document (Quality Assurance Surveillance Plan) specifying the surveillance methodology will be used for surveillance of contractor performance.

Reasonable Commuting Distance. During the entire performance of these services, each contractor is expected to demonstrate and utilize maximum cost control measures in order to minimize the need for claimant travel beyond the 100 mile radius outside each urban MSA cluster.

Region to be Served/Metropolitan Statistical Area. Kansas City District Office: Arkansas, Iowa, Kansas, Missouri, and Nebraska; all employees of the Department of Labor, except Job Corps enrollees and their relatives.

“Required” Medical Specialties for the region to be served - 8. Orthopedic surgery, Psychiatry, Otolaryngology, Neurology, Neuro-Surgery, Dermatology, Pulmonology and Physical Medicine and

Rehabilitation (PRM).

“Other Medical Specialties for the Region to be Served: Occupational medicine, cardiology, allergy and immunology, internal medicine, oncology, general surgery and urology. Emergency medicine, endocrinology, diabetes and metabolism, gastroenterology, hematology, immunology, infectious diseases, nephrology, rheumatology, nuclear medicine, gynecology, medical toxicology, ophthalmology, plastic surgery, radiology, diagnostic intervention, colorectal surgery, vascular surgery, thoracic surgery.

Acronyms

CO – Contracting Officer

COR - Contracting Officer’s Representative:

DFEC – Division of Federal Employees’ Compensation

DOL - Department of Labor

FAR – Federal Acquisition Regulation

IDIQ –Indefinite Delivery Indefinite Quantity

IT – Information Technology

OASAM – Office of the Assistant Secretary for Administration and Management

OMB - Office of Management and Budget

OWCP - Office of Workers’ Compensation Programs

POP – Period of Performance

PWS – Performance Work Statement

QCP - Quality Control Plan

QASP - Quality Assurance Surveillance Plan

SECOP - Second Opinion Examination

SOW – Statement of Work

PART 3 - GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

C.3.1 General:

The claim files associated with these services are in the custody of the District Office therefore, the Government will provide to the contractor all necessary information pertaining to each referral and the covered claimant.

The contractor shall protect from unauthorized disclosure any materials or information made available by the

Government, or that the contractor has access to by virtue of the provisions of this contract, that are not intended for public disclosure.

The material and information made available to the contractor by the Government, or that the contractor comes into contact with in completing this contract, are the exclusive property of the Government. Any information or materials developed by the Contractor in performance of this contract are also the exclusive property of the

Government. Upon completion or termination of this contract, the contractor shall turn over to the Government all materials (copies included) that were furnished to the Contractor by the Government and all materials that were developed by the Contractor in the performance of this contract.

Online Forms

OWCP's Division of Federal Employees' Compensation has made a variety of forms available online. The forms are only available in PDF format at http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm. In order to view and/or print

PDF documents you must have a PDF viewer. It is highly recommended that you have the most current version (click on Adobe Acrobat Reader to download the most recent version) available on your workstation. The Medical Second Opinion Forms in the list below may be completed manually via the print form option or electronically via the electronic fill option:

Form Number Description

OWCP 5A Work Capacity Evaluation, Psychiatric/Psychological Conditions

OWCP 5B Work Capacity Evaluation, Cardiovascular/Pulmonary Conditions

OWCP 5C Work Capacity Evaluation for Musculoskeletal Conditions

CA-17 Duty Status Report

CA-1332 Outline for Otologic Evaluation

HCFA-1500 Health Insurance Claim Form with Instructions http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm http://www.dol.gov/cgi-bin/leave-dol.asp?exiturl=http://www.adobe.com/products/acrobat/readstep2.html&exitTitle=Adobe_Acrobat_Reader

Equipment:

The services required do not require the Government to provide equipment in performance of these services.

Services:

Utilities.

The services required do not require the Government to provide utilities in performance of these services.

Facilities:

The services required do not require the Government to provide the workspace including desk space, telephones, computers and other items necessary to perform these services.

PART 4 - CONTRACTOR FURNISHED ITEMS AND SERVICES

C.4.1. General:

Except for those items specifically stated to be government furnished in Part 3 “Government Furnished Property” the contractor shall furnish all labor and material necessary to provide medical second opinion and examination services as required by the PWS.

Certificate of Liability Insurance

Prior to award, the apparent successful offeror shall submit evidence of its insurability concerning the medical liability insurance required by Section I, 52.237-7 “Indemnification and Medical Liability Insurance” at no less than the minimum required coverage for the region to be served. The contractor is also required to maintain such insurance in an amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned. The contractor shall ensure all subcontractors are appropriately insured and shall provide such proof, when requested, to the contracting officer. The offerors Certificate of Medical Liability Insurance shall be provided annually or as requested by the Contracting Officer.

Hold Harmless and Indemnification Agreement

The contractor shall save and hold harmless and indemnify the Government against any and all liability, claims, and costs of whatever, kind of nature to include injury to or death of any person or persons and for loss or damage to any property occurring in connection with, or in any way under the terms of this contract, resulting in whole or in part from the negligent act or omissions of the Contractor or subcontractor.

Government Liability

The Government shall not be liable for any injury to the Contractor’s personnel or damage to the Contractor’s property unless such injury or damage is due to negligence on the part of the Government and is recoverable under the Federal…